Get Wc 8359k Form

The Wc 8359k Form, also known as the Employer's Report of Occupational Injury or Illness, is essential for documenting work-related injuries or illnesses. This guide provides you with clear and step-by-step instructions to complete the form effectively online.

Follow the steps to complete the Wc 8359k Form online.

1. Click ‘Get Form’ button to obtain the form and open it in a digital editor.
2. Provide the firm name, policy number, and complete the mailing address section with your organization's details.
3. Indicate the location of the incident if it differs from the mailing address and provide the location code.
4. Describe the nature of your business to provide context regarding the injury or incident.
5. Fill in the state unemployment insurance account number to ensure proper reporting.
6. Select the type of employer from the options provided: private, state, county, or city.
7. Input the date of injury or onset of illness in the appropriate format (mm/dd/yy).
8. Specify the time when the injury or illness occurred.
9. Record the time the employee began work on that day.
10. If applicable, note the date of death if the employee passed away due to the incident.
11. Indicate if the employee was unable to work for at least one full day, and provide the date last worked.
12. Provide the date the employee returned to work, or check the box if they are still off work.
13. Indicate whether you are continuing the employee's salary during the period of absence.
14. Complete the section on the specific injury or illness sustained, detailing the part of the body affected.
15. Fill out the details related to the location of the incident, including address and county.
16. Specify whether the event occurred on the employer’s premises and the department involved.
17. Note if other workers were injured in the same event.
18. List the equipment, materials, and chemicals involved during the incident.
19. Describe the specific activity the employee was performing at the time of the incident.
20. Explain how the injury or illness occurred, detailing the sequence of events leading to the injury.
21. Provide the name and address of the physician who treated the employee.
22. Indicate whether the employee was hospitalized overnight and provide the hospital’s details if applicable.
23. State whether the employee received treatment in the emergency room.
24. Complete the employee's personal details, including name, social security number, and date of birth.
25. Fill out the home address and phone number of the employee.
26. Document the employee's occupational title, date of hire, and typical work hours.
27. Indicate the employment status and complete any additional payments not classified as wages.
28. Once all sections are completed, review the form for accuracy, save your changes, and proceed to download, print, or share the form as needed.

Complete your Wc 8359k Form online today for efficient processing.